Nov 10, 2016: India has moved to 3rd position out of 205 countries that has pictorial health warnings on tobacco packages. India’s earlier ranking was 136 in 2014 and 123 in 2012.

This was revealed byCigarette Package Health Warnings International Status Reportwhich was released today by Canadian Cancer Society in Delhi, India, at the 7th session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC), being held from November 7–12 at India Expo Mart, Greater Noida.

The report ranks 205 countries and territories on the size of their health warnings on cigarette packages and lists countries and territories that require graphic picture warnings. The report shows a significant global momentum toward plain packaging with 4 countries requiring plain packs and 14 working on it. The report also shows that 105 countries and territories have required picture health warnings on cigarette packages. This significant milestone in global public health will reduce smoking and save lives.

This is the 5th Canadian Cancer Society international report on cigarette package health warnings. Previous reports were published in 2008, 2010, 2012 and 2014.

The top countries ranked by warning size, as an average of the front and back of the package, are:

1. 90% Nepal

1. 90% Vanuatu

3. 85% Thailand3. 85% India

5. 82.5% Australia (75% front, 90% back)

6. 80% Sri Lanka
6. 80% Uruguay

8. 75% Brunei
8. 75% Canada

8. 75% Laos

8. 75% Myanmar

(In this list, the warning size is the same on the front and back, except in Australia).

According to Rob Cunningham, Senior Policy Analyst, Canadian Cancer Society, “India has demonstrated global leadership by implementing 85% pictorial warnings on all tobacco packages. This accomplishment is praiseworthy as it has been achieved despite fierce opposition from the tobacco industry. India will serve as a very positive model for other countries, thus benefitting public health worldwide”

The report highlights include:

105 countries and territories have finalized picture warning requirements, an increase from the 77 that had implemented these requirements by the end of 2014. In 2001, Canada was the first country to require picture warnings and to require a 50% size.

58% of the world’s population is covered by the 105 countries and territories that have finalized picture warning requirements.

Nepal has the largest warnings in the world with picture warnings covering 90% of the package front and back. Vanuatu will also require 90% picture warnings in 2017. India and Thailand have the next largest warnings at 85% of the front and back.

94 countries and territories require warnings to cover at least 50% of the package front and back (on average), up from 60 countries in 2014 and 24 in 2008.

The implementation by most European Union (EU) countries of the new EU requirement for 65% picture warnings was an important development contributing to the increase since 2014 in the number of countries requiring picture warnings.

Cigarette package warnings are a highly cost-effective way to increase awareness of the negative health effects of smoking and to reduce tobacco use. Picture-based warnings convey a more powerful message than a text-only warning, and larger ones increase impact. Picture warnings are especially valuable for low- and middle-income countries where there are higher rates of illiteracy and where governments may have few resources.

Guidelines under the WHO-FCTC treaty also recommend that countries consider implementing plain packaging. Plain packaging includes health warnings on packages, but prohibits Tobacco Company branding, such as colours, logos and design elements, and requires the brand portion of each package to be the same colour, such as an unattractive brown. The brand name would still appear, in a standard font size, style and location. The package format is standardized. Plain packaging puts an end to packaging being used for product promotion, increases the effectiveness of package warnings, curbs package deception and decreases tobacco use.

Plain packaging has been required in Australia (effective in 2012), the United Kingdom and France (effective May 20, 2016, at the manufacturer level) and Hungary (effective in 2018). The 14 countries working on plain packaging are: New Zealand, Ireland, Norway, Canada, Slovenia, Uruguay, Thailand, Singapore, Belgium, Romania, Turkey, Finland, Chile and South Africa.

Tobacco related diseases kills about 2500 Indians daily and over 10 lakh Indians every year. And it is estimated that about 5500 youth and children (as young as 8 years old), initiate tobacco use daily. India has 12 crore tobacco users, according to the Global Adult Tobacco Survey. Tobacco-use also imposes enormous health and economic costs on the country. The total direct and indirect cost of diseases attributable to tobacco use was a staggering Rupees 1.04 lakh crore ($17 billion) in 2011 or 1.16% of India’s GDP.